A. Adeyoju - Academia.edu (original) (raw)

Papers by A. Adeyoju

Programme Grants for Applied Research, 2018

BackgroundProtein biomarkers with associations with the activity and outcomes of diseases are bei... more BackgroundProtein biomarkers with associations with the activity and outcomes of diseases are being identified by modern proteomic technologies. They may be simple, accessible, cheap and safe tests that can inform diagnosis, prognosis, treatment selection, monitoring of disease activity and therapy and may substitute for complex, invasive and expensive tests. However, their potential is not yet being realised.Design and methodsThe study consisted of three workstreams to create a framework for research: workstream 1, methodology – to define current practice and explore methodology innovations for biomarkers for monitoring disease; workstream 2, clinical translation – to create a framework of research practice, high-quality samples and related clinical data to evaluate the validity and clinical utility of protein biomarkers; and workstream 3, the ELF to Uncover Cirrhosis as an Indication for Diagnosis and Action for Treatable Event (ELUCIDATE) randomised controlled trial (RCT) – an ex...

Urology, 2019

OBJECTIVE To examine changes in outcome by the Leibovich score using contemporary and historic co... more OBJECTIVE To examine changes in outcome by the Leibovich score using contemporary and historic cohorts of patients presenting with renal cell carcinoma (RCC) PATIENTS AND METHODS Prospective observational multicenter cohort study, recruiting patients with suspected newly diagnosed RCC. A historical cohort of patients was examined for comparison. Metastasis-free survival (MFS) formed the primary outcome measure. Model discrimination and calibration were evaluated using Cox proportional hazard regression and the Kaplan-Meier method. Overall performance of the Leibovich model was assessed by estimating explained variation. RESULTS Seven hundred and six patients were recruited between 2011 and 2014 and RCC confirmed in 608 (86%) patients. Application of the Leibovich score to patients with localized clear cell RCC in this contemporary cohort demonstrated good model discrimination (c-index = 0.77) but suboptimal calibration, with improved MFS for intermediate-and high-risk patients (5-year MFS 85% and 50%, respectively) compared to the original Leibovich cohort (74% and 31%) and a historic (1998-2006) UK cohort (76% and 37%). The proportion of variation in outcome explained by the model is low and has declined over time (28% historic vs 22% contemporary UK cohort). CONCLUSION Prognostic models are widely employed in patients with localized RCC to guide surveillance intensity and clinical trial selection. However, the majority of the variation in outcome remains unexplained by the Leibovich model and, over time, MFS rates among intermediate-and highrisk classified patients have altered. These findings are likely to have implications for all such models used in this setting. UROLOGY 136: 162−168, 2020.

Annals of the Royal College of Surgeons of England, 2002

We have used this technique on several hundred patients over a 10-year period for the insertion o... more We have used this technique on several hundred patients over a 10-year period for the insertion of diaphyseal fixation screws in external fixation. We have found it to be simple and reliable with minimal additional radiation exposure to the patient's limb. We recommend this method of screw placement which is particularly relevant for fixator application in the femoral and humeral diaphysis, the distal tibia and forearm bones or any site where the bone has a circular cross-sectional appearance.

Annals of the Royal College of Surgeons of England, Jul 1, 2008

Annals of the Royal College of Surgeons of England, Jul 1, 2008

European Urology Supplements, 2016

Urology, 2005

A 22-year-old man presented with painful urinary retention. A Foley catheter was passed urethrall... more A 22-year-old man presented with painful urinary retention. A Foley catheter was passed urethrally, and 700 mL of urine was drained. The rectal examination revealed a 3-cm fluctuant swelling proximal to the prostate gland. Blood biochemistry revealed hyponatremia, hyperkalemia, and raised urea and creatinine. The biochemical abnormalities normalized after catheterization and intravenous fluids for 48 hours.

Journal of Endourology Endourological Society, Mar 1, 2011

Laparoscopic pyeloplasty is now widely practiced in the United Kingdom and considered the gold st... more Laparoscopic pyeloplasty is now widely practiced in the United Kingdom and considered the gold standard in the treatment of patients with ureteropelvic junction obstruction. The aim of this audit was to determine the national practice and outcomes for this procedure. The British Association of Urological Surgeons sent out standardized audit proformas in May 2008 to units across the United Kingdom inviting surgeons who were performing laparoscopic pyeloplasties to submit their results over the last 4 years. Data on the presentation, preoperative investigations, intra-perative details, and postoperative follow-up were collected centrally and inserted into a national database for analysis. There were 323 returns from a total of 30 surgeons. At a median follow-up of 4 months (1-24), the overall symptomatic and renographic failure rates were 10.3% and 8.7%, respectively. Mean operative time was 181 minutes (3--425 min); there were 18 (6%) conversions, 33 (10.5%) complications, and one (0.3%) mortality. Surgeons who submitted 10 or more returns had a lower conversion rate than surgeons submitting fewer than 10 (2.9% vs 14.7%). The median hospital stay was 3 days (1-34 d). There was no difference in failure and complication rate for the retroperitoneal and transperitoneal approaches, although the conversion rate was higher with the retroperitoneal approach. The results show that laparoscopic pyeloplasty, although achieving acceptable outcomes at a national level in the United Kingdom, had areas of practice that could be improved. It highlights the importance of a high-volume practice in achieving optimum results and the potential problems associated with the retroperitoneal approach.

European Urology Supplements, 2004

European Urology Supplements, 2007

European Urology Supplements, 2004

European Urology Supplements, 2015

Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology, 2004

A 34-year-old woman, 7 weeks into her first pregnancy, presented with bleeding per vaginum. An ul... more A 34-year-old woman, 7 weeks into her first pregnancy, presented with bleeding per vaginum. An ultrasound scan confirmed a missed abortion and a mass 3.3 6 2.7 6 1.8 cm over the left side of the bladder. She underwent a dilatation and curettage was referred to the urology unit. She denied any urinary symptoms or any previous pelvic surgery. Intravenous urogram showed a filling defect on the left side of the bladder with normal upper tracts. Initial cystoscopy showed slightly raised and oedematous mucosa and a cold cut biopsy showed non-specific inflammation. Magnetic resonance imaging (MRI) confirmed an intravesical mass of 2.5 6 2 cm on the left side , hence a repeat biopsy was performed both percutaneously using ultrasound guidance and by transurethral resection. Histology revealed scattered foci of endometriosis ( ). As the patient wanted children and has been completely asymptomatic, she has been referred back to the gynaecologist with our plans to monitor her bladder endoscopically.

BJU international, 2001

To investigate a method of diuresis renography where the radiopharmaceutical and frusemide (diure... more To investigate a method of diuresis renography where the radiopharmaceutical and frusemide (diuretic) are given simultaneously, in contrast to conventional renography which involves an intravenous injection with frusemide 20 min after administering the radiopharmaceutical (F + 20) or 15 min before (F - 15), with particular interest in the effect of this change on assessing split renal function and interpreting upper tract drainage dynamics. In a prospective study, 29 patients (18 women and 11 men, mean age 47 years, range 21--86) were assessed. Each patient had two renograms taken over a 48-h period, either by the F + 20 or F - 15, and the F + 0 method: Data for split renal function and drainage curves were obtained in the usual way. Two independent assessments of the drainage curves were obtained and the results compared. The split function assessments were identical (< 5% variation) in all but two patients; 26 of 29 (90%) gave identical conclusions about the drainage curves. Th...

British journal of urology, 1996

Journal of Clinical Urology, 2015

Objectives: Our aim was to evaluate changes in prostate cancer diagnosis and management and to ex... more Objectives: Our aim was to evaluate changes in prostate cancer diagnosis and management and to examine changes in the stage and grade of newly diagnosed prostate cancer in the North West of England over a 10-year period. Materials and methods: Data was collected concerning the diagnosis (including stage and grade) and management of newly diagnosed prostate cancer in the North West of England. There were three time points: 2003, 2007 and 2011 including a total of 648 patients. For assessment of median time changes Spearman's Rank correlation test was used, for the assessment of changes in Gleason grade and clinical stage Mann-Whitney U test was used, and assessment of positive margin rates was done with Fisher's test. Results: Median time from management decision to surgery has reduced from 46 (2003), 34 (2007) to 27 days (2011) (p=0.074). The proportion of patients managed with active surveillance has remained relatively constant over time (18%, 16% and 21% respectively). More minimally invasive, nerve-sparing prostatectomies are now performed, and positive margin rates have significantly reduced from 53% (2003) to 23% (2011) (p<0.001). Gleason grade significantly increased over time (p<0.001); Gleason 7 disease was diagnosed in 23% of patients in 2003, 32% in 2007 and 49% in 2011 (p<0.001).

Scandinavian Journal of Urology, 2014

The aim of this review was to discuss the most recent data from current trials of diethylstilboes... more The aim of this review was to discuss the most recent data from current trials of diethylstilboestrol (DES) to identify its present role in advanced prostate cancer treatment as new hormonal therapies emerge. The most relevant clinical studies using DES in castration-refractory prostate cancer (CRPC) were identified from the literature. The safety, efficacy, outcomes and mechanisms of action are summarized. In the age of chemotherapy this review highlights the efficacy of oestrogen therapy in CRPC. The optimal point in the therapeutic pathway at which DES should be prescribed remains to be established.

International Journal of Urology, 2014

smaller than 3 cm. 2 Although most renal tumors associated with BHDS behave in an indolent manner... more smaller than 3 cm. 2 Although most renal tumors associated with BHDS behave in an indolent manner, the presence of clear cell components in renal tumors could reflect a worse prognosis. 3 As FLCN is linked to the mammalian target of rapamycin pathway, mammalian target of rapamycin inhibitors could be effective for BHDS patients with metastasis. 2 The prompt preparation of international medical guideline for diagnosis and management in BHDS-associated renal tumors might be desirable.

Urology, 2007

To determine whether various anatomic factors predispose to a lower pole stone on one side compar... more To determine whether various anatomic factors predispose to a lower pole stone on one side compared with the other.

Programme Grants for Applied Research, 2018

BackgroundProtein biomarkers with associations with the activity and outcomes of diseases are bei... more BackgroundProtein biomarkers with associations with the activity and outcomes of diseases are being identified by modern proteomic technologies. They may be simple, accessible, cheap and safe tests that can inform diagnosis, prognosis, treatment selection, monitoring of disease activity and therapy and may substitute for complex, invasive and expensive tests. However, their potential is not yet being realised.Design and methodsThe study consisted of three workstreams to create a framework for research: workstream 1, methodology – to define current practice and explore methodology innovations for biomarkers for monitoring disease; workstream 2, clinical translation – to create a framework of research practice, high-quality samples and related clinical data to evaluate the validity and clinical utility of protein biomarkers; and workstream 3, the ELF to Uncover Cirrhosis as an Indication for Diagnosis and Action for Treatable Event (ELUCIDATE) randomised controlled trial (RCT) – an ex...

Urology, 2019

OBJECTIVE To examine changes in outcome by the Leibovich score using contemporary and historic co... more OBJECTIVE To examine changes in outcome by the Leibovich score using contemporary and historic cohorts of patients presenting with renal cell carcinoma (RCC) PATIENTS AND METHODS Prospective observational multicenter cohort study, recruiting patients with suspected newly diagnosed RCC. A historical cohort of patients was examined for comparison. Metastasis-free survival (MFS) formed the primary outcome measure. Model discrimination and calibration were evaluated using Cox proportional hazard regression and the Kaplan-Meier method. Overall performance of the Leibovich model was assessed by estimating explained variation. RESULTS Seven hundred and six patients were recruited between 2011 and 2014 and RCC confirmed in 608 (86%) patients. Application of the Leibovich score to patients with localized clear cell RCC in this contemporary cohort demonstrated good model discrimination (c-index = 0.77) but suboptimal calibration, with improved MFS for intermediate-and high-risk patients (5-year MFS 85% and 50%, respectively) compared to the original Leibovich cohort (74% and 31%) and a historic (1998-2006) UK cohort (76% and 37%). The proportion of variation in outcome explained by the model is low and has declined over time (28% historic vs 22% contemporary UK cohort). CONCLUSION Prognostic models are widely employed in patients with localized RCC to guide surveillance intensity and clinical trial selection. However, the majority of the variation in outcome remains unexplained by the Leibovich model and, over time, MFS rates among intermediate-and highrisk classified patients have altered. These findings are likely to have implications for all such models used in this setting. UROLOGY 136: 162−168, 2020.

Annals of the Royal College of Surgeons of England, 2002

We have used this technique on several hundred patients over a 10-year period for the insertion o... more We have used this technique on several hundred patients over a 10-year period for the insertion of diaphyseal fixation screws in external fixation. We have found it to be simple and reliable with minimal additional radiation exposure to the patient's limb. We recommend this method of screw placement which is particularly relevant for fixator application in the femoral and humeral diaphysis, the distal tibia and forearm bones or any site where the bone has a circular cross-sectional appearance.

Annals of the Royal College of Surgeons of England, Jul 1, 2008

Annals of the Royal College of Surgeons of England, Jul 1, 2008

European Urology Supplements, 2016

Urology, 2005

A 22-year-old man presented with painful urinary retention. A Foley catheter was passed urethrall... more A 22-year-old man presented with painful urinary retention. A Foley catheter was passed urethrally, and 700 mL of urine was drained. The rectal examination revealed a 3-cm fluctuant swelling proximal to the prostate gland. Blood biochemistry revealed hyponatremia, hyperkalemia, and raised urea and creatinine. The biochemical abnormalities normalized after catheterization and intravenous fluids for 48 hours.

Journal of Endourology Endourological Society, Mar 1, 2011

Laparoscopic pyeloplasty is now widely practiced in the United Kingdom and considered the gold st... more Laparoscopic pyeloplasty is now widely practiced in the United Kingdom and considered the gold standard in the treatment of patients with ureteropelvic junction obstruction. The aim of this audit was to determine the national practice and outcomes for this procedure. The British Association of Urological Surgeons sent out standardized audit proformas in May 2008 to units across the United Kingdom inviting surgeons who were performing laparoscopic pyeloplasties to submit their results over the last 4 years. Data on the presentation, preoperative investigations, intra-perative details, and postoperative follow-up were collected centrally and inserted into a national database for analysis. There were 323 returns from a total of 30 surgeons. At a median follow-up of 4 months (1-24), the overall symptomatic and renographic failure rates were 10.3% and 8.7%, respectively. Mean operative time was 181 minutes (3--425 min); there were 18 (6%) conversions, 33 (10.5%) complications, and one (0.3%) mortality. Surgeons who submitted 10 or more returns had a lower conversion rate than surgeons submitting fewer than 10 (2.9% vs 14.7%). The median hospital stay was 3 days (1-34 d). There was no difference in failure and complication rate for the retroperitoneal and transperitoneal approaches, although the conversion rate was higher with the retroperitoneal approach. The results show that laparoscopic pyeloplasty, although achieving acceptable outcomes at a national level in the United Kingdom, had areas of practice that could be improved. It highlights the importance of a high-volume practice in achieving optimum results and the potential problems associated with the retroperitoneal approach.

European Urology Supplements, 2004

European Urology Supplements, 2007

European Urology Supplements, 2004

European Urology Supplements, 2015

Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology, 2004

A 34-year-old woman, 7 weeks into her first pregnancy, presented with bleeding per vaginum. An ul... more A 34-year-old woman, 7 weeks into her first pregnancy, presented with bleeding per vaginum. An ultrasound scan confirmed a missed abortion and a mass 3.3 6 2.7 6 1.8 cm over the left side of the bladder. She underwent a dilatation and curettage was referred to the urology unit. She denied any urinary symptoms or any previous pelvic surgery. Intravenous urogram showed a filling defect on the left side of the bladder with normal upper tracts. Initial cystoscopy showed slightly raised and oedematous mucosa and a cold cut biopsy showed non-specific inflammation. Magnetic resonance imaging (MRI) confirmed an intravesical mass of 2.5 6 2 cm on the left side , hence a repeat biopsy was performed both percutaneously using ultrasound guidance and by transurethral resection. Histology revealed scattered foci of endometriosis ( ). As the patient wanted children and has been completely asymptomatic, she has been referred back to the gynaecologist with our plans to monitor her bladder endoscopically.

BJU international, 2001

To investigate a method of diuresis renography where the radiopharmaceutical and frusemide (diure... more To investigate a method of diuresis renography where the radiopharmaceutical and frusemide (diuretic) are given simultaneously, in contrast to conventional renography which involves an intravenous injection with frusemide 20 min after administering the radiopharmaceutical (F + 20) or 15 min before (F - 15), with particular interest in the effect of this change on assessing split renal function and interpreting upper tract drainage dynamics. In a prospective study, 29 patients (18 women and 11 men, mean age 47 years, range 21--86) were assessed. Each patient had two renograms taken over a 48-h period, either by the F + 20 or F - 15, and the F + 0 method: Data for split renal function and drainage curves were obtained in the usual way. Two independent assessments of the drainage curves were obtained and the results compared. The split function assessments were identical (< 5% variation) in all but two patients; 26 of 29 (90%) gave identical conclusions about the drainage curves. Th...

British journal of urology, 1996

Journal of Clinical Urology, 2015

Objectives: Our aim was to evaluate changes in prostate cancer diagnosis and management and to ex... more Objectives: Our aim was to evaluate changes in prostate cancer diagnosis and management and to examine changes in the stage and grade of newly diagnosed prostate cancer in the North West of England over a 10-year period. Materials and methods: Data was collected concerning the diagnosis (including stage and grade) and management of newly diagnosed prostate cancer in the North West of England. There were three time points: 2003, 2007 and 2011 including a total of 648 patients. For assessment of median time changes Spearman's Rank correlation test was used, for the assessment of changes in Gleason grade and clinical stage Mann-Whitney U test was used, and assessment of positive margin rates was done with Fisher's test. Results: Median time from management decision to surgery has reduced from 46 (2003), 34 (2007) to 27 days (2011) (p=0.074). The proportion of patients managed with active surveillance has remained relatively constant over time (18%, 16% and 21% respectively). More minimally invasive, nerve-sparing prostatectomies are now performed, and positive margin rates have significantly reduced from 53% (2003) to 23% (2011) (p<0.001). Gleason grade significantly increased over time (p<0.001); Gleason 7 disease was diagnosed in 23% of patients in 2003, 32% in 2007 and 49% in 2011 (p<0.001).

Scandinavian Journal of Urology, 2014

The aim of this review was to discuss the most recent data from current trials of diethylstilboes... more The aim of this review was to discuss the most recent data from current trials of diethylstilboestrol (DES) to identify its present role in advanced prostate cancer treatment as new hormonal therapies emerge. The most relevant clinical studies using DES in castration-refractory prostate cancer (CRPC) were identified from the literature. The safety, efficacy, outcomes and mechanisms of action are summarized. In the age of chemotherapy this review highlights the efficacy of oestrogen therapy in CRPC. The optimal point in the therapeutic pathway at which DES should be prescribed remains to be established.

International Journal of Urology, 2014

smaller than 3 cm. 2 Although most renal tumors associated with BHDS behave in an indolent manner... more smaller than 3 cm. 2 Although most renal tumors associated with BHDS behave in an indolent manner, the presence of clear cell components in renal tumors could reflect a worse prognosis. 3 As FLCN is linked to the mammalian target of rapamycin pathway, mammalian target of rapamycin inhibitors could be effective for BHDS patients with metastasis. 2 The prompt preparation of international medical guideline for diagnosis and management in BHDS-associated renal tumors might be desirable.

Urology, 2007

To determine whether various anatomic factors predispose to a lower pole stone on one side compar... more To determine whether various anatomic factors predispose to a lower pole stone on one side compared with the other.